Component Description

The Bowel Health section of the mobile exam center (MEC) interview (variable name prefix BHQ) provides personal interview data on fecal incontinence and defecating function for adults age 20 years and older.

Questions BHQ010 – BHQ040 comprise the Fecal Incontinence Severity Index (FISI) (Rockwood et al, 2000) which applies a type x frequency matrix to obtain the subject’s perception of symptom severity. The four symptoms composing the index are incontinence of gas, mucus, liquid stool, and solid stool. The FISI responses are weighted on a 1-20 point severity scale and a total FISI score can be calculated.

Question BHQ060 is the Bristol Stool Form Scale. The stool consistency scale has been used in a series of studies. These studies have shown that a subject’s rating of his/her own individual stools (Probert et al, 1993) is robustly correlated with measures of how long it takes radiopaque markers to pass through the gastrointestinal tract.

This component was first administered in the NHANES in 2005.

Eligible Sample

The target sample for the questions in this section is adults age 20 years and older. Frequency counts were verified during the preparation of the file.

Interview Setting and Mode of Administration

The Bowel Health (BHQ_E) section was administered in person in the MEC interview room to survey participants only; proxy respondents were not permitted.

For details on the administration of the Bowel Health (BHQ_E) section, please refer to the NHANES 2007-08 MEC Interviewer Exam Manual and the Bowel Health Computer Assisted Personal Interview (CAPI) Questionnaire on the NHANES website.

Quality Assurance & Quality Control

For details on the QA/QC process for this component, please refer to the NHANES 2007-08 Interviewer Procedure Manuals on the NHANES website.

Data Processing and Editing

Times per day responses to BHD050 (How often do you have bowel movements?) were converted to times per week so that all responses are in times per week units.

Analytic Notes

Survey participants with ostomies and gastrointestinal conditions such as irritable bowel syndrome are not identified in the data file.

Pregnant women were asked about their usual bowel habits when not pregnant.

Exam sample weights should be used for analyses. Please refer to the Analytic Guidelines for further details on the use of sample weights and other analytic issues. The Analytic Guidelines are available on the NHANES website.

References

Probert CJS, Emmett PM, Heaton KW. Intestinal transit time in the population calculated from self made observations of defecation. Journal of Epidemiology and Community Health 1993;47:331-333.

BHQ005 - CHECK ITEM

BOX 1. CHECK ITEM BHQ005: IF INTERVIEW DONE ONLY WITH SURVEY PARTICIPANT (CODED '1' IN RIQ005), CONTINUE WITH BHQ010. OTHERWISE, GO TO THE END OF SECTION.

Target:

Both males and females 20 YEARS - 150 YEARS

BHQ010 - Bowel leakage consisted of gas?

Variable Name:

BHQ010

SAS Label:

Bowel leakage consisted of gas?

English Text:

Next, we'd like to talk to you about bowel health. We'll start with accidental bowel leakage. There are four types of bowel leakage that can happen: leakage (passing) of gas, leakage of mucus, leakage of liquid stool, and leakage of solid stool. We will ask you about leakage of each of these one at a time. How often during the past 30 days have you had any amount of accidental bowel leakage that consisted of gas? Would you say . . .

English Instructions:

HAND CARD BHQ1
CAPI INSTRUCTION: HELP SCREEN SHOULD READ: The bowel is another name for the intestines. Other names for the bowel include guts or innards. Accidental bowel leakage is leaking from the bowel or intestines that can't be controlled. Leakage of gas is also called passing gas, passing wind, or farting.

Target:

Both males and females 20 YEARS - 150 YEARS

Code or Value

Value Description

Count

Cumulative

Skip to Item

1

2 or more times a day,

540

540

2

once a day,

453

993

3

2 or more times a week,

351

1344

4

once a week,

262

1606

5

1-3 times a month, or

590

2196

6

Never?

2960

5156

77

Refused

3

5159

99

Don't know

18

5177

.

Missing

530

5707

BHQ020 - Bowel leakage consisted of mucus?

Variable Name:

BHQ020

SAS Label:

Bowel leakage consisted of mucus?

English Text:

How often during the past 30 days have you had any amount of accidental bowel leakage that consisted of mucus?

English Instructions:

HAND CARD BHQ1
CAPI INSTRUCTION: HELP SCREEN SHOULD READ: Mucus is a thick, jelly-like substance made by the intestines that helps coat and protect the lining of the intestine. Mucus also helps stool pass through the large intestine and rectum more easily.

Target:

Both males and females 20 YEARS - 150 YEARS

Code or Value

Value Description

Count

Cumulative

Skip to Item

1

2 or more times a day,

6

6

2

once a day,

23

29

3

2 or more times a week,

24

53

4

once a week,

14

67

5

1-3 times a month, or

107

174

6

Never?

4984

5158

77

Refused

3

5161

99

Don't know

16

5177

.

Missing

530

5707

BHQ030 - Bowel leakage consisted of liquid?

Variable Name:

BHQ030

SAS Label:

Bowel leakage consisted of liquid?

English Text:

How often during the past 30 days have you had any amount of accidental bowel leakage that consisted of liquid stool?

English Instructions:

HAND CARD BHQ1
CAPI INSTRUCTION: HELP SCREEN SHOULD READ: Stool is also called a bowel movement, BM, or poop.

Target:

Both males and females 20 YEARS - 150 YEARS

Code or Value

Value Description

Count

Cumulative

Skip to Item

1

2 or more times a day,

12

12

2

once a day,

17

29

3

2 or more times a week,

38

67

4

once a week,

22

89

5

1-3 times a month, or

267

356

6

Never?

4804

5160

77

Refused

3

5163

99

Don't know

14

5177

.

Missing

530

5707

BHQ040 - Bowel leakage consisted of solid stool?

Variable Name:

BHQ040

SAS Label:

Bowel leakage consisted of solid stool?

English Text:

How often during the past 30 days have you had any amount of accidental bowel leakage that consisted of solid stool?

English Instructions:

HAND CARD BHQ1

Target:

Both males and females 20 YEARS - 150 YEARS

Code or Value

Value Description

Count

Cumulative

Skip to Item

1

2 or more times a day,

4

4

2

once a day,

15

19

3

2 or more times a week,

15

34

4

once a week,

11

45

5

1-3 times a month, or

70

115

6

Never?

5045

5160

77

Refused

3

5163

99

Don't know

14

5177

.

Missing

530

5707

BHD050 - How often have bowel movements?

Variable Name:

BHD050

SAS Label:

How often have bowel movements?

English Text:

How often do you usually have bowel movements?

English Instructions:

PROBE: How many times per week do you usually have a bowel movement?

Target:

Both males and females 20 YEARS - 150 YEARS

Code or Value

Value Description

Count

Cumulative

Skip to Item

1 to 84

Range of Values

5163

5163

777

Refused

2

5165

999

Don't know

12

5177

.

Missing

530

5707

BHQ060 - Common Stool Type

Variable Name:

BHQ060

SAS Label:

Common Stool Type

English Text:

Please look at this card and tell me the number that corresponds to your usual or most common stool type.